Botox for a Gummy Smile: What It Can—and Can’t—Do

You like your smile.

You like your teeth.

But every time you smile big for a picture, you notice one thing:

“Why do I show so much gum?”

You may have what people commonly call a gummy smile, or excessive gingival display.

And if you’ve spent five minutes searching TikTok or Instagram, you’ve probably already discovered:

“Apparently Botox can fix that.”

Sometimes it can help.

Want to know if it’s right for you? Learn more about Botox in Mesa, AZ at Allure Infinite Beauty.

But this is one of those treatments where the word “fix” can be misleading.

A gummy smile can happen for several completely different reasons. Botox only addresses certain muscle-related causes.

So before treating the upper lip, the more important question is:

Why are your gums showing in the first place?

At Allure Infinite Beauty in Mesa, Arizona, that’s where we believe the conversation should start.

What Is a Gummy Smile?

A gummy smile describes excessive gingival display—meaning more of the gum above the upper teeth becomes visible when you smile.

There isn’t one universally perfect amount of gum that everyone should show.

Some gingival display is completely normal.

And having a gummy smile isn’t a medical problem simply because you can see gum when someone smiles.

It’s primarily an aesthetic concern when you feel the amount of gum showing distracts from your smile.

Research and dental literature generally describe excessive gingival display as involving more visible gingiva than is considered aesthetically typical, but the exact threshold varies between studies.

The important part:

A gummy smile is a description of what you see—not a diagnosis of why it’s happening.

What Causes a Gummy Smile?

This is probably the most important section of the entire article.

Several completely different anatomical factors can create excessive gum show.

They can also occur together.

Common contributors include:

• A hypermobile upper lip
• A relatively short upper lip
• Excessive vertical development of the upper jaw
• Altered passive eruption of the teeth
• Tooth position
• Gingival overgrowth
• Dentoalveolar factors
• A combination of several causes

Dental literature consistently emphasizes that determining the cause of excessive gingival display is critical because different causes require different treatments.

That means:

Not every gummy smile is a Botox gummy smile.

When Can Botox Help a Gummy Smile?

Botulinum toxin can be useful when excessive muscle activity elevates the upper lip too far when smiling.

Think about what happens when you smile.

Several muscles help raise and move the upper lip.

In some people, those muscles are particularly active.

The lip may rise significantly when smiling and expose more gum than the person wants.

Botulinum toxin can temporarily reduce activity in selected upper-lip elevator muscles.

That may reduce how high the upper lip rises during a full smile.

Recent systematic reviews have found that botulinum toxin type A can reduce excessive gingival display, particularly when muscle hyperactivity contributes to the gummy smile.

That’s the ideal basic concept:

The lip moves too far upward → reduce some of that muscular pull → less gum may show.

But that’s only useful if excessive muscle movement is actually part of the problem.

What Muscles Cause a Gummy Smile?

Several muscles contribute to elevation of the upper lip during smiling.

Research on botulinum toxin treatment for gummy smiles frequently discusses muscles including the:

• Levator labii superioris alaeque nasi
• Levator labii superioris
• Zygomaticus minor

Which muscles are contributing depends on the person’s smile pattern and anatomy.

You don’t need to memorize those names.

What matters is this:

Your provider needs to understand them.

The muscles around the nose, mouth and upper lip contribute to expression and function.

This is not an area where we believe treatment should be based on:

“I saw an injection dot on Instagram right here.”

Is Botox for a Gummy Smile FDA Approved?

No.

A Botox gummy-smile treatment is considered an off-label cosmetic use.

Current FDA-approved cosmetic uses of BOTOX Cosmetic include temporary improvement of moderate to severe:

• Frown lines
• Crow’s feet
• Forehead lines
• Platysma bands

Gummy-smile treatment is not listed among those approved cosmetic indications.

That does not mean off-label treatment is automatically inappropriate.

Licensed medical providers routinely use medications off-label when they determine doing so is medically appropriate.

But it does mean your provider should be clear about what they’re doing, why they’re recommending it, and what limitations and risks apply.

What Does “Off-Label” Actually Mean?

This term scares people unnecessarily because it sounds like:

“experimental.”

That’s not what it means.

When a medication is FDA approved, the FDA approves specific indications, doses, populations and uses supported by the submitted evidence.

Healthcare providers can sometimes legally use an approved medication for a different purpose based on their clinical judgment.

That’s called off-label use.

Many aesthetic botulinum toxin treatments you’ve probably heard about are off-label.

A 2026 systematic review examining off-label aesthetic uses of botulinum toxin included applications such as gummy-smile correction, brow shaping, facial slimming, downturned mouth treatment and other cosmetic uses.

The distinction still matters.

Patients deserve to know when treatment differs from the medication’s FDA-approved cosmetic indications.

How Much Can Botox Reduce a Gummy Smile?

The answer varies.

A 2021 meta-analysis found an average reduction in gingival exposure of approximately 3.4 millimeters at two weeks, although results varied substantially between studies. The effect decreased over time and approached baseline by about 24 weeks.

A more recent 2024 systematic review found that the greatest effect generally occurred around two to four weeks after treatment, with effects in reviewed studies lasting roughly 12 to 24 weeks.

But those are research averages.

They are not a promise that your smile will move exactly three millimeters.

Your result depends on:

• Why your gummy smile exists
• How much gum you show
• Your muscle activity
• Your anatomy
• The specific treatment performed
• Your individual response

This is exactly why we don’t like guaranteeing:

“Botox will fix your gummy smile.”

The better statement is:

Botulinum toxin may reduce excessive gingival display when upper-lip muscle activity is a significant contributor.

How Many Units of Botox Does a Gummy Smile Need?

This is one area where we intentionally do not give patients a universal dosing chart.

There is no single FDA-approved Botox dose for gummy-smile treatment.

Research protocols also vary.

A systematic review specifically evaluating dose and injection location found meaningful variation among studies, with treatment being adapted to the severity and type of gummy smile.

Another review concluded that protocols varied widely and that no single standardized treatment approach had emerged, emphasizing individualized treatment based on anatomy and cause.

So if someone online says:

“Everybody needs exactly ___ units for a gummy smile,”

we’d be cautious.

The number is not the starting point.

Your smile is.

What Does a Gummy-Smile Consultation Look Like?

We’re obviously interested in what your smile looks like.

So we’re going to make you smile.

Probably more than once.

Your provider may want to evaluate:

• Your lips at rest
• How much tooth shows at rest
• Your natural smile
• Your biggest possible smile
• How far the upper lip travels
• Whether the movement is symmetrical
• Where the gums become visible
• Your tooth-to-gum proportions
• Whether the concern appears primarily muscular

The assessment of excessive gingival display can include static and dynamic lip evaluation, tooth display, gingival examination and facial analysis because the underlying cause determines the treatment.

A still selfie doesn’t always tell the whole story.

We need to see the smile happen.

When Botox Probably Won’t Fix a Gummy Smile

This is where the article becomes really important.

Suppose your upper lip movement is completely normal.

But you still show a lot of gum.

Why?

Maybe the cause isn’t muscular.

Excess Gum Covering the Teeth

Sometimes the teeth appear unusually short because more gum covers the natural tooth structure.

This can occur with something known as altered passive eruption.

Botox does not remove gum tissue.

Vertical Maxillary Excess

Sometimes the upper jaw has developed in a way that creates increased vertical facial height and gingival display.

Botox does not reposition the jaw.

Tooth Position

Orthodontic or dentoalveolar factors can influence how much gum is visible.

Botox does not move teeth.

Gingival Enlargement

If excess gum tissue itself is contributing, reducing lip movement does not correct the underlying gingival problem.

A Short Upper Lip

Lip anatomy can also contribute to excessive gingival display.

Botox changes muscle activity.

It does not physically lengthen the lip.

This is why diagnosis matters.

Literature on gummy smiles emphasizes that causes such as altered passive eruption, hypermobile lip, vertical maxillary excess and dental factors may require very different approaches.

How Do I Know If My Gummy Smile Is From a Hyperactive Upper Lip?

Here’s a clue.

Look at yourself with your mouth relaxed.

Then smile normally.

Then smile as big as possible.

If your upper lip travels a significant distance upward during smiling, muscular hypermobility may be contributing.

Research among patients seeking gummy-smile treatment has found hypermobile upper lip to be a common contributor, often occurring together with other causes such as altered passive eruption.

But don’t try to diagnose the entire issue from your bathroom mirror.

You can have more than one cause at the same time.

That’s where a professional evaluation matters.

Can Botox Completely Eliminate a Gummy Smile?

Sometimes a patient experiences significant improvement.

But complete elimination isn’t something we should universally promise.

The goal is usually to reduce excessive upward lip movement—not stop the upper lip from functioning.

Your smile still needs to be a smile.

And if structural or dental causes are also contributing, Botox may only address the muscular component.

Imagine your gummy smile is caused by:

50% lip hypermobility + 50% tooth/gum anatomy.

Reducing the muscle activity doesn’t magically correct the second half.

This is why some people need an interdisciplinary approach involving dental, periodontal, orthodontic or surgical expertise depending on the underlying cause.

Will Botox Change the Way I Smile?

Potentially.

And patients should understand that before treatment.

That’s the entire mechanism.

We’re intentionally changing muscle activity involved in the smile.

Ideally, the change simply reduces how high the upper lip rises.

But treatment around the mouth can also potentially affect:

• Smile symmetry
• Lip movement
• Expression
• Certain mouth movements

A systematic review of botulinum toxin treatment for excessive gingival display found reported adverse events were generally mild and transient, but the literature still supports a patient-specific approach because injection methods and anatomy vary.

This is why precision matters.

You don’t want to simply paralyze the upper lip.

You want to appropriately reduce the unwanted component of movement while preserving a natural smile.

Can a Gummy-Smile Treatment Make My Smile Uneven?

It’s possible for changes in muscle activity to affect symmetry.

Remember:

Your face probably wasn’t perfectly symmetrical before treatment either.

One side may naturally:

• Lift higher
• Contract more strongly
• Show more tooth
• Show more gum
• Smile differently

That’s why your provider should evaluate you while you’re moving.

If one side already moves differently, that’s information we need before treatment.

Perfect mathematical symmetry is not a realistic promise in cosmetic medicine.

But understanding your baseline helps us determine what’s natural for your face.

Is Gummy-Smile Botox the Same as a Lip Flip?

No.

This is an easy one to confuse.

Both treatments involve neuromodulators around the upper lip.

But the goal is different.

Gummy-Smile Treatment

The goal is generally to reduce excessive upward elevation of the upper lip during smiling.

Lip Flip

The goal is generally to relax selected activity around the lip border so a small amount of the upper lip may become more visible.

Neither adds volume the way filler does.

And neither should simply be treated as:

“Botox around the mouth.”

Which muscle we’re trying to influence matters.

We’ll cover that in detail in our upcoming guide:

Lip Flip vs Lip Filler: Which One Actually Fits Your Goal?

Gummy-Smile Botox vs Lip Filler

These are also very different.

Botox

Changes muscle activity.

Filler

Adds volume or structural support.

If your concern is:

“My upper lip disappears when I smile,”

we need to determine why.

Is it rolling inward?

Is it being pulled upward excessively?

Is the lip naturally thin?

Are you actually bothered by gum exposure?

Those may lead to completely different conversations.

Don’t choose treatment based solely on the final appearance you saw in someone else’s before-and-after.

Can Lip Filler Fix a Gummy Smile?

Not necessarily.

Adding volume to the lip is not the same thing as treating excessive gingival display.

In some cases, modifying lip proportions may change how the smile looks cosmetically.

But filler does not correct every cause of a gummy smile, and simply making the lip larger isn’t automatically the right answer.

Start with:

Why am I showing gum?

Then choose treatment.

Not the other way around.

What Other Treatments Can Correct a Gummy Smile?

The appropriate alternative depends entirely on the cause.

Depending on the diagnosis, treatment options outside a medspa may include things such as:

• Periodontal treatment
• Esthetic crown lengthening
• Orthodontic treatment
• Lip repositioning procedures
• Dental treatment
• Oral or maxillofacial surgical evaluation

For example, altered passive eruption and hypermobile upper lip are different conditions and can require different approaches.

We don’t need to pretend Allure performs every possible treatment.

Sometimes the best recommendation is:

“This looks like something you should discuss with the appropriate dental or surgical specialist.”

That’s still excellent patient care.

How Quickly Does Botox Work for a Gummy Smile?

Because this is an off-label application, there isn’t an FDA-approved gummy-smile treatment timeline.

However, clinical studies generally report the strongest reductions in excessive gum display during the first several weeks after treatment.

A 2024 systematic review found maximum effect typically around two to four weeks.

That means you shouldn’t evaluate your final smile the evening after treatment.

Give the medication time to affect the targeted muscle activity and follow the evaluation timeline recommended by your provider.

How Long Does Gummy-Smile Botox Last?

It’s temporary.

Research generally shows the effect gradually decreases over several months.

A 2024 systematic review reported effects lasting roughly 12 to 24 weeks, while a meta-analysis found gum exposure gradually returned toward baseline by approximately 24 weeks.

Individual results vary.

And because this is temporary, someone who likes the result would generally need repeat treatment to maintain it.

That’s important to understand before starting.

Does the Gummy Smile Come Back Worse?

Botulinum toxin does not permanently change the underlying anatomy causing the gummy smile.

As its effect decreases, the treated muscles regain activity.

Your smile therefore tends to move back toward its pretreatment pattern.

That doesn’t inherently mean the treatment created a worse gummy smile.

You may simply become more aware of your original amount of gingival display after spending several months seeing less of it.

Is Botox Better Than Surgery for a Gummy Smile?

That’s the wrong comparison.

The two aren’t automatically competing treatments.

If your gummy smile is primarily from a hypermobile upper lip, temporary neuromodulator treatment may be an appealing nonsurgical option.

If it’s primarily caused by skeletal anatomy, significant altered passive eruption or another structural issue, Botox may not address the actual problem.

Research consistently emphasizes tailoring treatment to the cause of the excessive gingival display.

So the better question is:

Which treatment addresses my specific cause?

Who Might Be a Good Candidate for Gummy-Smile Botox?

A medical consultation is necessary, but the conversation may make sense if:

• Excessive gum display bothers you
• Your upper lip rises significantly when smiling
• Muscle hyperactivity appears to be an important contributor
• You understand the result is temporary
• You’re comfortable with the treatment being off-label
• You have realistic expectations about the amount of change

It is not appropriate for everyone.

Who Might Not Get What They Want From Botox?

Botox may disappoint someone whose gummy smile is primarily caused by:

• Excess gingival tissue
• Significant vertical maxillary excess
• Dental positioning
• Tooth-proportion concerns
• Structural anatomy rather than muscle activity

It may also disappoint someone expecting:

“I never want to see any gum when I smile again.”

That’s not necessarily a realistic or desirable treatment goal.

Natural smiles move.

Our goal is usually to improve the feature bothering you without making your smile look like it belongs to someone else.

What If I Like My Big Smile?

Then tell us.

Seriously.

This is important.

Maybe you like your smile.

You just want slightly less gum showing.

That’s very different from wanting maximum possible reduction.

You should not have to choose between:

your personality

and

your cosmetic treatment.

If your big expressive smile is part of what makes you look like you, the treatment plan should respect that.

This is why we keep coming back to the same idea throughout our Botox guides:

“Natural” isn’t a number of units.

It’s a treatment plan built around what you want to preserve.

What Should You Tell Your Injector Before Gummy-Smile Botox?

Tell them:

• What specifically bothers you about your smile
• Whether the concern happens only during a full smile
• Whether one side lifts more than the other
• Whether you’ve had Botox, Dysport or another neuromodulator before
• Whether you’ve had filler around the lips
• Whether you’ve had dental, orthodontic or periodontal procedures
• Whether you’ve had previous facial surgery
• Your complete medical and medication history
• What you absolutely do not want changed about your smile

And ask:

“Do you think my gummy smile is actually muscular?”

That’s probably more valuable than asking:

“How many units do I need?”

Is Botox for a Gummy Smile Safe?

Botulinum toxin has been studied for excessive gingival display, and systematic reviews generally report favorable safety findings with mostly mild and temporary complications in the published studies.

But BOTOX Cosmetic remains a prescription medication with important contraindications and warnings.

Its official safety information includes a boxed warning regarding the possible spread of toxin effects, and serious symptoms such as problems swallowing, speaking or breathing require urgent medical attention.

Treatment around the mouth also requires particular respect for muscles involved in normal facial movement.

Common does not mean casual.

Why We Don’t Treat Every Gummy Smile the Same

This is where we think aesthetic medicine should slow down a little.

Social media often simplifies treatment into:

Problem → injection point → before-and-after.

Real anatomy isn’t that simple.

Imagine three people walk into Allure.

Patient A

Her teeth and gums look proportionate, but her upper lip flies upward dramatically when she smiles.

Muscular treatment might be worth discussing.

Patient B

His lip movement is fairly normal, but his teeth look unusually short because a larger portion is covered by gum tissue.

That’s a different problem.

Patient C

She has significant gingival display related to skeletal and dental anatomy.

Again—different problem.

All three people could Google:

“How do I fix my gummy smile?”

And all three could need different answers.

That’s why the consultation matters more than the trend.

Our Approach to Gummy Smiles at Allure Infinite Beauty

If you come into Allure and say:

“I want Botox for my gummy smile,”

we aren’t offended if our first response is:

“Smile for us.”

Then smile bigger.

Then relax.

We want to understand:

• How far your upper lip travels
• Where the gum is visible
• Whether one side behaves differently
• Your lip proportions
• Your teeth-to-gum relationship
• Whether the concern appears primarily muscular
• What you actually want your smile to look like

Then we can talk.

Maybe Botox or another neuromodulator makes sense.

Maybe a small change could create exactly the result you’re hoping for.

Maybe we think part of the issue should be evaluated by a dentist, periodontist, orthodontist or another specialist.

And sometimes we may tell you:

“I don’t think Botox is going to fix what you’re pointing at.”

That’s not losing a treatment.

That’s doing the consultation correctly.

Frequently Asked Questions About Botox for a Gummy Smile

Can Botox fix a gummy smile?

Botulinum toxin may reduce excessive gum display when overactivity of the upper-lip elevator muscles contributes to the gummy smile. It cannot correct every cause, such as significant skeletal, dental or gingival factors.

Is Botox for a gummy smile FDA approved?

No. Gummy-smile treatment is an off-label cosmetic use. Current FDA-approved cosmetic BOTOX indications include frown lines, crow’s feet, forehead lines and platysma bands in adults.

How many units of Botox are needed for a gummy smile?

There is no universal FDA-approved gummy-smile dose. Published protocols vary based on anatomy, severity and treatment approach, which is why dosing should be determined individually by the treating medical provider.

How long does gummy-smile Botox last?

Studies generally show a temporary effect lasting several months. Research reviews have reported effects in the range of approximately 12–24 weeks, with the result gradually decreasing over time.

How quickly will I see results?

Research suggests the maximum reduction in gingival display often occurs approximately two to four weeks after botulinum toxin treatment.

Will gummy-smile Botox change my smile?

It intentionally changes activity in muscles involved in raising the upper lip, so some change in smile movement is expected. The treatment goal and potential effects on expression should be discussed before treatment.

Can gummy-smile Botox make my smile crooked?

Changes in muscle activity can potentially affect symmetry, particularly because most faces have some natural asymmetry to begin with. Proper assessment of your baseline smile is important.

Is a gummy-smile treatment the same as a lip flip?

No. Both may involve botulinum toxin around the upper lip, but the muscle targets and treatment goals differ.

Does lip filler fix a gummy smile?

Not necessarily. Filler adds volume, while a botulinum toxin gummy-smile treatment changes muscle activity. The appropriate treatment depends on why excess gum is showing.

Can Botox fix a gummy smile caused by excess gum tissue?

Botox does not remove gingival tissue. When gum or tooth anatomy is an important cause, periodontal or dental treatment may be more appropriate.

Can Botox fix a gummy smile caused by my jaw?

Botox cannot reposition the upper jaw. Significant skeletal causes require evaluation by the appropriate dental or surgical specialist.

Will my gummy smile be worse when Botox wears off?

The neuromodulator effect is temporary, so muscle movement and gingival display generally move back toward baseline as the medication wears off. That does not mean Botox inherently makes the original condition worse.

Looking for Gummy-Smile Botox in Mesa, Arizona?

If you’re bothered by how much gum shows when you smile, you don’t need to figure out the diagnosis before your consultation.

And you definitely don’t need to walk in knowing how many units you need.

Just smile.

Show us what bothers you.

Tell us:

“I love my smile, but I wish a little less gum showed.”

or

“My entire upper lip disappears upward when I smile.”

or even:

“I saw this treatment online and I don’t know if I’m actually a candidate.”

That’s enough.

At Allure Infinite Beauty in Mesa, Arizona, our licensed medical providers can evaluate whether upper-lip muscle movement appears to be contributing and whether neuromodulator treatment is an appropriate option.

And if the problem doesn’t look primarily muscular?

We’ll tell you.

Because our goal isn’t to make Botox somehow become the answer to every cosmetic concern.

The goal is to understand the problem first—and then choose the treatment that actually makes sense.

Allure Infinite Beauty
1130 W. Grove Ave., #114
Mesa, AZ 85210
480-831-7109

Serving Mesa, Gilbert, Chandler, Tempe and the surrounding East Valley.

This article is intended for general educational purposes and is not individualized medical advice. Cosmetic botulinum toxin treatment for excessive gingival display is an off-label use. BOTOX Cosmetic is a prescription medication with contraindications, warnings and potential adverse effects. Treatment should be performed by an appropriately licensed healthcare professional after evaluation of your anatomy, medical history, risks and treatment goals.